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Article ; Online: Use of metamizole and other non-opioid analgesics in Switzerland between 2014 and 2019: an observational study using a large health insurance claims database.

Gut, Stephan / Rauch, Marlene / Haschke, Manuel / Huber, Carola A / Gaertner, Jan / Schur, Nadine / Meier, Christoph R / Spoendlin, Julia

Swiss medical weekly

2024 Volume 154, Page(s) 3535

Abstract: Objective: To investigate claims patterns for metamizole and other non-opioid analgesics in Switzerland. To characterise users of these non-opioid analgesics regarding sex, age, comedications and canton of residence.: Methods: We conducted a ... ...

Abstract	Objective: To investigate claims patterns for metamizole and other non-opioid analgesics in Switzerland. To characterise users of these non-opioid analgesics regarding sex, age, comedications and canton of residence. Methods: We conducted a retrospective descriptive study using administrative claims data of outpatient prescribed non-opioid analgesics of the Swiss health insurance company Helsana between January 2014 and December 2019. First, we evaluated the number of claims and defined daily doses per year of metamizole, ibuprofen, diclofenac and paracetamol in adults aged 18 years or over. Second, we characterised new users of these non-opioid analgesics in terms of sex, age, claimed comedications and canton of residence. Results: From 2014 to 2019, among the investigated non-opioid analgesics, metamizole showed the highest increase in claims (+9545 claims, +50%) and defined daily doses (+86,869 defined daily doses, +84%) per 100,000 adults. Metamizole users had the highest median age (62 years [IQR: 44-77]) compared to ibuprofen (47 years [IQR: 33-62]), diclofenac (57 years [IQR: 43-71]) and paracetamol (58 years [IQR: 39-75]) users. Metamizole users also more frequently claimed proton pump inhibitors, anticoagulants, platelet aggregation inhibitors and antihypertensive drugs than users of other non-opioid analgesics. While metamizole was most frequently claimed in German-speaking regions of Switzerland, ibuprofen and paracetamol were most frequently claimed in the French-speaking regions and diclofenac in German- and Italian-speaking regions. Conclusion: In Switzerland, metamizole was increasingly claimed between 2014 and 2019. Metamizole was most frequently claimed by older adults and patients with comedications suggestive of underlying conditions, which can be worsened or caused by use of nonsteroidal anti-inflammatory drugs. The lack of studies regarding the effectiveness and safety of metamizole in this population warrants further investigation.
MeSH term(s)	Humans ; Aged ; Adult ; Middle Aged ; Analgesics, Non-Narcotic ; Dipyrone/therapeutic use ; Acetaminophen/therapeutic use ; Switzerland ; Ibuprofen/therapeutic use ; Diclofenac/therapeutic use ; Retrospective Studies ; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use ; Analgesics, Opioid ; Insurance, Health
Chemical Substances	Analgesics, Non-Narcotic ; Dipyrone (6429L0L52Y) ; Acetaminophen (362O9ITL9D) ; Ibuprofen (WK2XYI10QM) ; Diclofenac (144O8QL0L1) ; Anti-Inflammatory Agents, Non-Steroidal ; Analgesics, Opioid
Language	English
Publishing date	2024-02-05
Publishing country	Switzerland
Document type	Observational Study ; Journal Article
ZDB-ID	2036179-8
ISSN	1424-3997 ; 1424-7860
ISSN (online)	1424-3997
ISSN	1424-7860
DOI	10.57187/s.3535
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Article ; Online: Utilisation patterns and costs of lipid-lowering drugs in Switzerland 2013-2019.

Reinau, Daphne / Schur, Nadine / Twerenbold, Sibylle / Blozik, Eva / Früh, Mathias / Signorell, Andri / Schwenkglenks, Matthias / Meier, Christoph R

Swiss medical weekly

2021 Volume 151, Page(s) w30018

Abstract: Objective: To analyse utilisation patterns of lipid-lowering drugs and the related costs in Switzerland between the years 2013 and 2019.: Methods: We conducted a retrospective descriptive study using administrative claims data of persons aged ≥18 ... ...

Abstract	Objective: To analyse utilisation patterns of lipid-lowering drugs and the related costs in Switzerland between the years 2013 and 2019. Methods: We conducted a retrospective descriptive study using administrative claims data of persons aged ≥18 years enrolled with the health insurance company Helsana. To enable statements at the Swiss population level, results were extrapolated according to age, sex and canton of residence. Results: The overall prevalence of patients taking lipid-lowering drugs rose from 8.9% (n = 736,174) in 2013 to 11.6% (n = 841,682) in 2019, but varied markedly across regions, with highest values in Ticino and lowest values in Zurich. More than every third individual aged ≥65 years was treated with a lipid-lowering drug in 2019. Statins were by far the most commonly used drugs (>90% of prescriptions), followed by ezetimibe, fibrates and PCSK9 inhibitors. We observed a trend towards the prescription of more potent statins (atorvastatin, rosuvastatin) in recent years. Total costs of lipid-lowering drugs increased from CHF 222 million in 2013 to CHF 230 million in 2019 (+3.5%), whereas annual per capita costs decreased from CHF 302 in 2013 to CHF 273 in 2019 (-9.4%). Conclusion: The increasing use of lipid-lowering drugs reflects current therapeutic guidelines, but results in high costs for the healthcare system.
MeSH term(s)	Adult ; Anticholesteremic Agents/economics ; Anticholesteremic Agents/therapeutic use ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/economics ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use ; Hypolipidemic Agents/economics ; Hypolipidemic Agents/therapeutic use ; PCSK9 Inhibitors ; Retrospective Studies ; Switzerland
Chemical Substances	Anticholesteremic Agents ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Hypolipidemic Agents ; PCSK9 Inhibitors ; PCSK9 protein, human (EC 3.4.21.-)
Language	English
Publishing date	2021-09-01
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2036179-8
ISSN	1424-3997 ; 1424-7860
ISSN (online)	1424-3997
ISSN	1424-7860
DOI	10.4414/SMW.2021.w30018
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Article ; Online: Cost Effectiveness and Budget Impact of Siponimod Compared to Interferon Beta-1a in the Treatment of Adult Patients with Secondary Progressive Multiple Sclerosis with Active Disease in Switzerland.

Schur, Nadine / Gudala, Kapil / Vudumula, Umakanth / Vadapalle, Sreelatha / Bhadhuri, Arjun / Casanova, Alain / Adlard, Nicholas / Schwenkglenks, Matthias

PharmacoEconomics

2021 Volume 39, Issue 5, Page(s) 563–577

Abstract: Objective: The study aim was to evaluate the cost effectiveness and budget impact of siponimod compared to interferon beta-1a for adult patients with secondary progressive multiple sclerosis (SPMS) with active disease, from a Swiss health insurance ... ...

Abstract	Objective: The study aim was to evaluate the cost effectiveness and budget impact of siponimod compared to interferon beta-1a for adult patients with secondary progressive multiple sclerosis (SPMS) with active disease, from a Swiss health insurance perspective. Methods: We conducted an analysis using a Markov cohort model with a cycle length of 1 year, life-long time horizon, and discount rate of 3% for cost and health outcomes. We used a matching-adjusted indirect comparison to estimate clinical outcomes using data from the EXPAND randomised controlled trial of siponimod vs placebo and the Nordic SPMS randomised controlled trial of interferon beta-1a vs placebo as the basis for estimates of disability progression and relapse outcomes. We used 6-month confirmed disability progression results to estimate disability progression in the base-case analysis. We calculated quality-adjusted life-years (QALYs) based on an external study that administered the EQ-5D-3L questionnaire to European patients with multiple sclerosis. We included costs (Swiss Franc (CHF), year 2020) of drug acquisition/administration, adverse events and disease management. We also performed a budget impact analysis to estimate the cost over the first 3 years of introducing siponimod. Results: For the base case, siponimod resulted in mean incremental costs of CHF 84,901 (siponimod: CHF 567,838, interferon beta-1a: CHF 482,937) and mean incremental QALYs of 1.591 (siponimod: 7.495, interferon beta-1a: 5.905), leading to an incremental cost-effectiveness ratio of CHF 53,364 per QALY gained. In the probabilistic sensitivity analysis, the probability of the cost effectiveness of siponimod assuming a willingness-to-pay threshold of CHF 100,000 per QALY gained was 90%. Siponimod was projected to result in drug administration costs for siponimod of CHF 23,817,856 in the first 3 years after introduction, accompanied by large cost offsets in drug acquisition of other multiple sclerosis drugs. Considering drug administration, monitoring and adverse event management costs, it was estimated to result in additional healthcare costs in Switzerland of CHF 2,177,021. Conclusions: In the base-case analysis, we found that siponimod may be cost effective for treating Swiss adult patients with SPMS with active disease. The results of the cost-effectiveness analyses are valid under the assumption that the efficacy of siponimod and the comparators on disability progression for the overall SPMS population would be the same in the active SPMS population. Clinical trial identifier: NCT01665144. This economic evaluation was based on the EXPAND trial.
MeSH term(s)	Adult ; Azetidines ; Benzyl Compounds ; Cost-Benefit Analysis ; Humans ; Interferon beta-1a ; Multiple Sclerosis ; Multiple Sclerosis, Chronic Progressive ; Quality-Adjusted Life Years ; Switzerland
Chemical Substances	Azetidines ; Benzyl Compounds ; siponimod (RR6P8L282I) ; Interferon beta-1a (XRO4566Q4R)
Language	English
Publishing date	2021-04-01
Publishing country	New Zealand
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	1100273-6
ISSN	1179-2027 ; 1170-7690
ISSN (online)	1179-2027
ISSN	1170-7690
DOI	10.1007/s40273-021-01023-8
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Article: Coverage rates and timeliness of nationally recommended vaccinations in Swiss preschool children: A descriptive analysis using claims data

Schneider, Rahel / Reinau, Daphne / Schur, Nadine / Blozik, Eva / Früh, Mathias / Signorell, Andri / Heininger, Ulrich / Schwenkglenks, Matthias / Meier, Christoph R

Vaccine. 2020 Feb. 05, v. 38, no. 6

2020

Abstract: Low vaccination coverage as well as incomplete and delayed vaccinations pose a risk for the individual and population protection from vaccine-preventable diseases.To describe vaccination patterns for nationally recommended basic and supplementary ... ...

Abstract	Low vaccination coverage as well as incomplete and delayed vaccinations pose a risk for the individual and population protection from vaccine-preventable diseases.To describe vaccination patterns for nationally recommended basic and supplementary vaccinations in Swiss preschool children.We performed a descriptive study based on administrative claims data from a large Swiss health insurer (Helsana), in cohorts of children born between January 2010 and December 2016. We assessed coverage rates of nationally recommended basic vaccinations (i.e., diphtheria, tetanus, acellular pertussis [DTaP], Haemophilus influenzae type b [Hib], poliomyelitis [IPV], measles, mumps, and rubella [MMR]) and supplementary vaccinations (i.e., pneumococcal conjugate vaccine [PCV] and meningococcal group C conjugate vaccine [MCV]) for each birth cohort at the age of 13, 25, and 37 months. Additionally, we analysed timeliness of vaccinations using inverse Kaplan-Meier curves. Results were extrapolated to the Swiss population.The study population comprised 563,216 children. We observed continuously increasing coverage rates for all vaccinations until the 2015 birth cohort. Overall, up-to-date status for the first dose of studied vaccinations at 37 months was as follows: DTaP: 95.4%; Hib: 94.9%; IPV: 95.5%; MMR: 86.8%; PCV: 83.2%; and MCV: 66.7%. On average, however, only seven out of ten children had an up-to-date status for completed basic vaccinations; even less (six out of ten) were up-to-date for recommended supplementary vaccinations at 37 months of age. Moreover, 4% of all analysed children received none of the recommended vaccinations and there were substantial regional differences. Delays in vaccine administration were common. The most frequently postponed basic vaccination was MMR; 22.6% of children vaccinated with the first dose experienced delays relative to age-appropriate standards.To avoid future outbreaks and transmission of vaccine-preventable diseases, vaccination coverage in Switzerland must be further improved. In addition, more emphasis should be placed on timely vaccination.
Keywords	Haemophilus influenzae ; Streptococcus pneumoniae ; descriptive studies ; diphtheria ; disease transmission ; measles ; preschool children ; risk ; tetanus ; vaccination ; vaccines ; Switzerland
Language	English
Dates of publication	2020-0205
Size	p. 1551-1558.
Publishing place	Elsevier Ltd
Document type	Article
ZDB-ID	605674-x
ISSN	1873-2518 ; 0264-410X
ISSN (online)	1873-2518
ISSN	0264-410X
DOI	10.1016/j.vaccine.2019.11.057
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Modelling age-heterogeneous Schistosoma haematobium and S. mansoni survey data via alignment factors

Utzinger Jürg / Schur Nadine / Vounatsou Penelope

Parasites & Vectors, Vol 4, Iss 1, p

2011 Volume 142

Abstract: Abstract Background Reliable maps of the geographical distribution, number of infected individuals and burden estimates of schistosomiasis are essential tools to plan, monitor and evaluate control programmes. Large-scale disease mapping and prediction ... ...

Abstract	Abstract Background Reliable maps of the geographical distribution, number of infected individuals and burden estimates of schistosomiasis are essential tools to plan, monitor and evaluate control programmes. Large-scale disease mapping and prediction efforts rely on compiled historical survey data obtained from the peer-reviewed literature and unpublished reports. Schistosomiasis surveys usually focus on school-aged children, whereas some surveys include entire communities. However, data are often reported for non-standard age groups or entire study populations. Existing geostatistical models ignore either the age-dependence of the disease risk or omit surveys considered too heterogeneous. Methods We developed Bayesian geostatistical models and analysed existing schistosomiasis prevalence data by estimating alignment factors to relate surveys on individuals aged ≤ 20 years with surveys on individuals aged > 20 years and entire communities. Schistosomiasis prevalence data for 11 countries in the eastern African region were extracted from an open-access global database pertaining to neglected tropical diseases. We assumed that alignment factors were constant for the whole region or a specific country. Results Regional alignment factors indicated that the risk of a Schistosoma haematobium infection in individuals aged > 20 years and in entire communities is smaller than in individuals ≤ 20 years, 0.83 and 0.91, respectively. Country-specific alignment factors varied from 0.79 (Ethiopia) to 1.06 (Zambia) for community-based surveys. For S. mansoni , the regional alignment factor for entire communities was 0.96 with country-specific factors ranging from 0.84 (Burundi) to 1.13 (Uganda). Conclusions The proposed approach could be used to align inherent age-heterogeneity between school-based and community-based schistosomiasis surveys to render compiled data for risk mapping and prediction more accurate.
Keywords	Microbiology ; QR1-502 ; Science ; Q ; DOAJ:Microbiology ; DOAJ:Biology ; DOAJ:Biology and Life Sciences ; Infectious and parasitic diseases ; RC109-216 ; Internal medicine ; RC31-1245 ; Medicine ; R ; DOAJ:Internal medicine ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
Subject code	310
Language	English
Publishing date	2011-07-01T00:00:00Z
Publisher	BioMed Central
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Cost-effectiveness of a structured medication review approach for multimorbid older adults: Within-trial analysis of the OPERAM study.

Salari, Paola / O'Mahony, Cian / Henrard, Séverine / Welsing, Paco / Bhadhuri, Arjun / Schur, Nadine / Roumet, Marie / Beglinger, Shanthi / Beck, Thomas / Jungo, Katharina Tabea / Byrne, Stephen / Hossmann, Stefanie / Knol, Wilma / O'Mahony, Denis / Spinewine, Anne / Rodondi, Nicolas / Schwenkglenks, Matthias

PloS one

2022 Volume 17, Issue 4, Page(s) e0265507

Abstract: Background: Inappropriate polypharmacy has been linked with adverse outcomes in older, multimorbid adults. OPERAM is a European cluster-randomized trial aimed at testing the effect of a structured pharmacotherapy optimization intervention on preventable ...

Abstract	Background: Inappropriate polypharmacy has been linked with adverse outcomes in older, multimorbid adults. OPERAM is a European cluster-randomized trial aimed at testing the effect of a structured pharmacotherapy optimization intervention on preventable drug-related hospital admissions in multimorbid adults with polypharmacy aged 70 years or older. Clinical results of the trial showed a pattern of reduced drug-related hospital admissions, but without statistical significance. In this study we assessed the cost-effectiveness of the pharmacotherapy optimisation intervention. Methods: We performed a pre-planned within-trial cost-effectiveness analysis (CEA) of the OPERAM intervention, from a healthcare system perspective. All data were collected within the trial apart from unit costs. QALYs were computed by applying the crosswalk German valuation algorithm to EQ-5D-5L-based quality of life data. Considering the clustered structure of the data and between-country heterogeneity, we applied Generalized Structural Equation Models (GSEMs) on a multiple imputed sample to estimate costs and QALYs. We also performed analyses by country and subgroup analyses by patient and morbidity characteristics. Results: Trial-wide, the intervention was numerically dominant, with a potential cost-saving of CHF 3'588 (95% confidence interval (CI): -7'716; 540) and gain of 0.025 QALYs (CI: -0.002; 0.052) per patient. Robustness analyses confirmed the validity of the GSEM model. Subgroup analyses suggested stronger effects in people at higher risk. Conclusion: We observed a pattern towards dominance, potentially resulting from an accumulation of multiple small positive intervention effects. Our methodological approaches may inform other CEAs of multi-country, cluster-randomized trials facing presence of missing values and heterogeneity between centres/countries.
MeSH term(s)	Aged ; Cost-Benefit Analysis ; Humans ; Medication Review ; Multimorbidity ; Polypharmacy ; Quality of Life
Language	English
Publishing date	2022-04-11
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0265507
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Article ; Online: Drug prescription patterns, polypharmacy and potentially inappropriate medication in Swiss nursing homes: a descriptive analysis based on claims data.

Schneider, Rahel / Reinau, Daphne / Schur, Nadine / Blozik, Eva / Früh, Mathias / Signorell, Andri / Meier, Christoph R / Schwenkglenks, Matthias

Swiss medical weekly

2019 Volume 149, Page(s) w20126

Abstract: Background: To date, comprehensive data on drug utilisation in Swiss nursing homes are lacking.: Objective: To describe drug prescription patterns, polypharmacy and potentially inappropriate medication (PIM) in Swiss nursing home residents (NHR).: ... ...

Abstract	Background: To date, comprehensive data on drug utilisation in Swiss nursing homes are lacking. Objective: To describe drug prescription patterns, polypharmacy and potentially inappropriate medication (PIM) in Swiss nursing home residents (NHR). Methods: Using administrative claims data provided by the Swiss health insurance company Helsana, we assessed drug claims and drug costs in 2016 in individuals aged ≥65 years and insured with Helsana, who were either NHR or living in the community (reference group, RG). In particular, we analysed the prevalence of polypharmacy (≥5 claims for different drugs during a 3-month period) and PIM use according to the 2015 Beers criteria and the PRISCUS list. We standardised the results to the Swiss population. Results: In 2016, NHR had on average nearly twice as many drug claims per capita as individuals in the RG (NHR 58.8; RG 30.8). The average per capita drug costs per day for NHR were low, but higher than in the RG (NHR CHF 8.55; RG CHF 5.45). The same pattern applied to the prevalence of polypharmacy (NHR 85.5%; RG 50.4%). Standardisation by age and sex did not materially alter these observations. Overall, 79.1% of NHR received ≥1 PIM, and 56.2% were long-term users (≥3 claims) of at least one PIM (based on the combined PRISCUS list and Beers criteria). Among all PIMs in nursing homes, quetiapine (antipsychotic agent), lorazepam (anxiolytic agent) and zolpidem (hypnotic agent) were the most prevalent (22.4, 20.2 and 13.0%, respectively). Conclusions: The high prevalence of polypharmacy and PIM in Swiss nursing homes may indicate a need for interventions aiming at de-prescribing drugs with an unfavourable benefit-risk profile.
MeSH term(s)	Aged ; Aged, 80 and over ; Drug Prescriptions/economics ; Drug Prescriptions/statistics & numerical data ; Drug Utilization/statistics & numerical data ; Female ; Humans ; Insurance Claim Review ; Insurance, Health ; Male ; Nursing Homes ; Pharmacy ; Polypharmacy ; Prescription Drug Misuse ; Switzerland
Language	English
Publishing date	2019-09-30
Publishing country	Switzerland
Document type	Comparative Study ; Journal Article
ZDB-ID	2036179-8
ISSN	1424-3997 ; 1424-7860
ISSN (online)	1424-3997
ISSN	1424-7860
DOI	10.4414/smw.2019.20126
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Article ; Online: Coverage rates and timeliness of nationally recommended vaccinations in Swiss preschool children: A descriptive analysis using claims data.

Schneider, Rahel / Reinau, Daphne / Schur, Nadine / Blozik, Eva / Früh, Mathias / Signorell, Andri / Heininger, Ulrich / Schwenkglenks, Matthias / Meier, Christoph R

Vaccine

2019 Volume 38, Issue 6, Page(s) 1551–1558

Abstract: Background: Low vaccination coverage as well as incomplete and delayed vaccinations pose a risk for the individual and population protection from vaccine-preventable diseases.: Aim: To describe vaccination patterns for nationally recommended basic ... ...

Abstract	Background: Low vaccination coverage as well as incomplete and delayed vaccinations pose a risk for the individual and population protection from vaccine-preventable diseases. Aim: To describe vaccination patterns for nationally recommended basic and supplementary vaccinations in Swiss preschool children. Methods: We performed a descriptive study based on administrative claims data from a large Swiss health insurer (Helsana), in cohorts of children born between January 2010 and December 2016. We assessed coverage rates of nationally recommended basic vaccinations (i.e., diphtheria, tetanus, acellular pertussis [DTaP], Haemophilus influenzae type b [Hib], poliomyelitis [IPV], measles, mumps, and rubella [MMR]) and supplementary vaccinations (i.e., pneumococcal conjugate vaccine [PCV] and meningococcal group C conjugate vaccine [MCV]) for each birth cohort at the age of 13, 25, and 37 months. Additionally, we analysed timeliness of vaccinations using inverse Kaplan-Meier curves. Results were extrapolated to the Swiss population. Results: The study population comprised 563,216 children. We observed continuously increasing coverage rates for all vaccinations until the 2015 birth cohort. Overall, up-to-date status for the first dose of studied vaccinations at 37 months was as follows: DTaP: 95.4%; Hib: 94.9%; IPV: 95.5%; MMR: 86.8%; PCV: 83.2%; and MCV: 66.7%. On average, however, only seven out of ten children had an up-to-date status for completed basic vaccinations; even less (six out of ten) were up-to-date for recommended supplementary vaccinations at 37 months of age. Moreover, 4% of all analysed children received none of the recommended vaccinations and there were substantial regional differences. Delays in vaccine administration were common. The most frequently postponed basic vaccination was MMR; 22.6% of children vaccinated with the first dose experienced delays relative to age-appropriate standards. Conclusion: To avoid future outbreaks and transmission of vaccine-preventable diseases, vaccination coverage in Switzerland must be further improved. In addition, more emphasis should be placed on timely vaccination.
MeSH term(s)	Child, Preschool ; Humans ; Immunization Schedule ; Infant ; Switzerland ; Vaccination Coverage/statistics & numerical data ; Vaccines/administration & dosage
Chemical Substances	Vaccines
Language	English
Publishing date	2019-11-30
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	605674-x
ISSN	1873-2518 ; 0264-410X
ISSN (online)	1873-2518
ISSN	0264-410X
DOI	10.1016/j.vaccine.2019.11.057
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Article ; Online: A scoping review shows that several nonvalidated budget planning tools for randomized trials are available.

Speich, Benjamin / Gloy, Viktoria / Schur, Nadine / Ewald, Hannah / Hemkens, Lars G / Schwenkglenks, Matthias / Briel, Matthias

Journal of clinical epidemiology

2019 Volume 117, Page(s) 9–19

Abstract: Objectives: We aimed to provide a systematic overview of freely available tools which may help plan or monitor costs for randomized clinical trials (RCTs).: Study design and setting: We systematically searched MEDLINE, EMBASE, and EconLit and ... ...

Abstract	Objectives: We aimed to provide a systematic overview of freely available tools which may help plan or monitor costs for randomized clinical trials (RCTs). Study design and setting: We systematically searched MEDLINE, EMBASE, and EconLit and conducted internet searches via Google (last search, October 2018). We included all freely available tools and determined their specific purpose, which parts of clinical trial projects and which types of costs they covered, and if they were user-tested or validated in any form. Results: We identified 25 available tools. Most tools were downloadable on websites from institutions related to clinical research. Seven tools were developed to plan the budget for an entire RCT, 17 tools for calculating budgets of an individual trial center, and one tool for monitoring costs of ongoing RCTs. Eighteen tools considered fixed, variable, and indirect costs. Only two tools were clearly user-tested or validated. Conclusion: Several freely available tools aim to support investigators in planning costs of an entire trial or in planning the budget for a clinical trial site. How valid and useful they are remains to be shown for most of them. Future tools should be openly shared, user-tested, and validated.
MeSH term(s)	Costs and Cost Analysis/methods ; Humans ; Internet ; Randomized Controlled Trials as Topic/economics ; Research Personnel
Language	English
Publishing date	2019-09-15
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Systematic Review
ZDB-ID	639306-8
ISSN	1878-5921 ; 0895-4356
ISSN (online)	1878-5921
ISSN	0895-4356
DOI	10.1016/j.jclinepi.2019.09.009
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Article ; Online: Determining treatment needs at different spatial scales using geostatistical model-based risk estimates of schistosomiasis.

Schur, Nadine / Vounatsou, Penelope / Utzinger, Jürg

PLoS neglected tropical diseases

2012 Volume 6, Issue 9, Page(s) e1773

Abstract: Background: After many years of neglect, schistosomiasis control is going to scale. The strategy of choice is preventive chemotherapy, that is the repeated large-scale administration of praziquantel (a safe and highly efficacious drug) to at-risk ... ...

Abstract	Background: After many years of neglect, schistosomiasis control is going to scale. The strategy of choice is preventive chemotherapy, that is the repeated large-scale administration of praziquantel (a safe and highly efficacious drug) to at-risk populations. The frequency of praziquantel administration is based on endemicity, which usually is defined by prevalence data summarized at an arbitrarily chosen administrative level. Methodology: For an ensemble of 29 West and East African countries, we determined the annualized praziquantel treatment needs for the school-aged population, adhering to World Health Organization guidelines. Different administrative levels of prevalence aggregation were considered; country, province, district, and pixel level. Previously published results on spatially explicit schistosomiasis risk in the selected countries were employed to classify each area into distinct endemicity classes that govern the frequency of praziquantel administration. Principal findings: Estimates of infection prevalence adjusted for the school-aged population in 2010 revealed that most countries are classified as moderately endemic for schistosomiasis (prevalence 10-50%), while four countries (i.e., Ghana, Liberia, Mozambique, and Sierra Leone) are highly endemic (>50%). Overall, 72.7 million annualized praziquantel treatments (50% confidence interval (CI): 68.8-100.7 million) are required for the school-aged population if country-level schistosomiasis prevalence estimates are considered, and 81.5 million treatments (50% CI: 67.3-107.5 million) if estimation is based on a more refined spatial scale at the provincial level. Conclusions/significance: Praziquantel treatment needs may be over- or underestimated depending on the level of spatial aggregation. The distribution of schistosomiasis in Ethiopia, Liberia, Mauritania, Uganda, and Zambia is rather uniform, and hence country-level risk estimates are sufficient to calculate treatment needs. On the other hand, countries like Burkina Faso, Mali, Mozambique, Sudan, and Tanzania show large spatial heterogeneity in schistosomiasis risk, which should be taken into account for calculating treatment requirements.
MeSH term(s)	Adolescent ; Africa/epidemiology ; Anthelmintics/therapeutic use ; Chemoprevention/methods ; Child ; Child, Preschool ; Female ; Humans ; Male ; Praziquantel/therapeutic use ; Prevalence ; Schistosomiasis/drug therapy ; Schistosomiasis/epidemiology ; Schistosomiasis/prevention & control ; Topography, Medical
Chemical Substances	Anthelmintics ; Praziquantel (6490C9U457)
Language	English
Publishing date	2012-09-13
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2429704-5
ISSN	1935-2735 ; 1935-2727
ISSN (online)	1935-2735
ISSN	1935-2727
DOI	10.1371/journal.pntd.0001773
Database	MEDical Literature Analysis and Retrieval System OnLINE

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